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. 2011 Dec 7;2011(12):CD008691. doi: 10.1002/14651858.CD008691.pub2

Modi 2006.

Clinical features and settings Clinical features
  • ESKD patients with hypertension on maintenance dialysis undergoing pre‐transplant coronary angiography as per the institutional protocol if they were aged > 40 years to rule out CAD as part of transplant workup


Setting
  • Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India

Participants
  • Number: 105

  • DM: 61/105 (58%)

  • Hypertension: all were hypertensive

  • Sex: 102 (97.1%) male

  • Age (mean ± SD): 51.6 ± 6.2 years (range 38 to 64 years)

Study design Cross sectional study.
Target condition and reference standard(s) Coronary artery stenosis measured by coronary angiography
  • CAD defined as presence of ≥ 1 coronary arteries with ≥ 50% diameter stenosis

Index and comparator tests CIMT measurement
  • CIMT measurement was conducted on USG B mode 7.5 MHZ probe. At least three readings were taken, and the average of three readings was taken for evaluation. IMT on both sides was calculated and averaged. Plaques were defined as focal widening relative to the adjacent segments, with protrusion into the lumen, composed either of only calcified deposits or a combination of calcification and non‐calcified material. The site and extent of lesions were not quantified.

  • Patients were further divided into two groups according to average CIMT (average IMT > 0.75 mm and those with IMT < 0.75 mm).

Follow‐up None reported.
Notes  
Table of Methodological Quality
Item Authors' judgement Description
Representative spectrum? 
 All tests Yes ESKD patients undergoing cardiac evaluation as part of transplant workup.
Acceptable reference standard? 
 All tests Yes Yes, coronary angiography with a reference standard threshold of ≥ 50% stenosis.
Acceptable delay between tests? 
 All tests Unclear Unclear, but likely to be only short delay between tests.
Partial verification avoided? 
 All tests Yes All participants who received an index test received the reference standard test.
Differential verification avoided? 
 All tests Yes This was not an issue in this study. Disease status (CAD) is diagnosed only through coronary angiography.
Incorporation avoided? 
 All tests Yes This was not an issue in this study. Disease status (CAD) is diagnosed only through coronary angiography.
Reference standard results blinded? 
 All tests Yes Reference standard performed before index test. Therefore it was not influenced by results of index test.
Index test results blinded? 
 All tests Yes An operator, who was blinded with respect to the results of the coronary angiography, measured CIMT in all patients prior to coronary angiography and recorded it on videotape. Two independent observers who were blinded to the result of coronary angiography, measured CIMT offline to validate its predictive accuracy as a noninvasive test in predicting the presence or absence of CAD.
Relevant clinical information? 
 All tests Yes Relevant clinical information was provided regarding the performance and analysis of both the index and reference tests.
Uninterpretable results reported? 
 All tests Yes No results were reported to be uninterpretable.
Withdrawals explained? 
 All tests Yes No withdrawals were present.